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  11. The Evolution Of An Epidemic: Age-period-cohort Modelling Of Mesothelioma In Casale Monferrato, 1990-2021, With Projections To 2042

The evolution of an epidemic: age-period-cohort modelling of mesothelioma in Casale Monferrato, 1990-2021, with projections to 2042

Margarita Giraldo1,2, Daniela Zugna3, Enrica Migliore3,4

  • 1Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin, Turin, Italy. mm.giraldo337@uniandes.edu.co.

Environmental Health : a Global Access Science Source
|October 22, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Malignant mesothelioma (MM) rates in Casale Monferrato, Italy, are projected to decline steadily, with the epidemic potentially ending by mid-century. Despite this, the health burden will persist for two decades, necessitating ongoing environmental health surveillance.

Area of Science:

  • Epidemiology
  • Environmental Health
  • Public Health

Background:

  • Casale Monferrato, Italy, has a high burden of malignant mesothelioma (MM) due to historical asbestos contamination from the Eternit plant.
  • The area is a Site of National Interest (SIN) for environmental and health concerns.
  • Despite the asbestos ban, the MM epidemic continues due to the disease's long latency.

Purpose of the Study:

  • To describe MM trends in Casale Monferrato's SIN from 1990-2021.
  • To project future MM incidence through 2042 using Age-Period-Cohort (APC) models.

Main Methods:

  • Utilized data from the Piedmont Malignant Mesothelioma Registry (RMM).
  • Employed APC models with restricted cubic splines to estimate incidence rates.
  • Evaluated projection models by comparing predicted and observed cases.
Keywords:
APC modelsAsbestosCasale MonferratoIncidence rates

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Main Results:

  • Recorded 1,282 pleural MM cases (1990-2021), with significant occupational exposure in men and non-occupational exposures in women.
  • Incidence increased with age and birth cohort (up to 1945), peaking in the mid-2010s before declining.
  • All projection models consistently forecast a decline, with incidence returning to early 1990s levels by 2035 and significantly lower rates by 2042.

Conclusions:

  • Consistent projections indicate MM epidemic extinction around mid-century.
  • A significant health burden from MM is expected to persist for the next two decades.
  • Sustained environmental health surveillance is crucial in Casale Monferrato.
Incidence trends
Pleural malignant mesothelioma
Projections